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General NPI Number Information
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NPI Number | 1942485735
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Entity Type | Individual
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Provider Name | SAMEER ANSAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 5668 E STATE ST SUITE 2000
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City | ROCKFORD
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State | IL
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Zip | 61108-2490
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Country | US
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Telephone | 815-381-7790
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Fax |
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Provider Business Mailing Address
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Address Line | 5668 E STATE ST SUITE 2000
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City | ROCKFORD
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State | IL
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Zip | 61108-2490
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Country | US
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Telephone | 815-381-7790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036119752
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 40260
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-119752
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036-119752
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License Number State | IL
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